NPIMap

Organization Active NPI

Radiant Flux PLLC

Doing business as Center for Sleep & TMJ

  • Dentist
  • Suffolk, VA
National Provider Identifier
1477255859
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RADIANT FLUX PLLC
Doing business as
Center for Sleep & TMJ
Practice address
1301 Bridgeport Way Ste 109
Suffolk, VA 23435-1960
Phone
(757) 929-7100
Fax
(757) 929-7097
NPI assigned
Mar 20, 2023
Last updated
Mar 21, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
RADIANT FLUX PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Brian Gene Briesemeister, DDSNPI 1205202256
Title
Executive
Phone
(757) 929-7100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

1301 Bridgeport Way Ste 109
Suffolk, VA 23435-1960

Mailing address

1301 Bridgeport Way Ste 109
Suffolk, VA 23435-1960
Phone (757) 929-7100

Other names 1

  • Center for Sleep & TMJ Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220518001828 VA DME Supplier - Oral Surgery - Dentist 6709263478 Practice locations: Suffolk, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Radiant Flux PLLC5 organizations share this tax ID, including this one
Part of
Radiant Flux PLLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1477255859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BRIDGEPORT WAY STE 109",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351960",
            "telephone_number": "757-929-7100",
            "fax_number": "757-929-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BRIDGEPORT WAY STE 109",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351960",
            "telephone_number": "757-929-7100",
            "fax_number": "757-929-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT FLUX PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIANT FLUX PLLC",
        "enumeration_date": "2023-03-20",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "BRIESEMEISTER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GENE",
        "authorized_official_title_or_position": "EXECUTIVE",
        "authorized_official_telephone_number": "757-929-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Sleep & TMJ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.